Flare Up

[Sped53]

I have been off prednisone for a year but lately have been having a return of the pain and stiffness. Have any of you just gone back on prednisone short term to calm the pain and stiffness down? I’m thinking of just starting back on a low dose (maybe 5 mg) to see if that makes a difference.

Also night time is the worst. I wake up multiple times in a lot of pain. Do any of you take prednisone before bed?

I don’t want to start all over again on higher doses and have to taper over the next year again!

[SheffieldJane]

Are you sure that it’s not arthritis? Mine is pinging away with all the wet weather.If it definitely is PMR pain, perhaps a blood test would confirm. You are going to have to bite the bullet and get on top of the inflammation. The longer you wait the worse it will get. Maybe try 10 mgs and see if that works. You won’t be the first to have a relapse.

[PMRpro Ambassador]

It is perfectly possible that it could be a second episode of PMR - and yes, I know you don't want to hear that. I have a few friends who have had PMR twice, a couple of years apart. If the PMR is relapsing, then a short course of pred won't just "calm it down" but if you catch it quickly you may find something under 5mg is enough. Prof Dasgupta told us last year that he often keeps patients on 2-3mg long term as it reduces the risk of relapses.

Is it the same as PMR was last time? Or is it different in any way? When and where is the pain at night?

[Notsoclever]

I would avoid taking pred at night- many more side-effects are reported compared with taking it in the morning, and it’s more physiological to take it early in the day. Good luck!